Malunion vs. Nonunion Fractures

Rest and immobilization are typically prescribed to allow for natural bone healing after a fracture. This strategy, along with forms of casting, can help rehabilitate many different fractures with minimal complications. However, in some cases, bones do not heal properly even after traditionally effective treatments.

Malunion and nonunion fractures are two types of bone healing complications. These can often occur as a result of a significant trauma. These complex fractures make restoring function after injury a challenge. Both malunion and nonunion fractures can occur following damage to any of the body’s 206 bones.

MaCalus V. Hogan, MD, from the UPMC Department of Orthopaedic Surgery explains, “The treatment of fracture malunions and nonunions often requires an orthopaedic surgical team approach. The keys to successful treatment are early identification of the problem, and initiation of a treatment plan geared toward improving patient function, recovery, and return to their normal activities of daily living.”

To help further explain these conditions, consult the following condition and treatment overviews.

Malunion

A malunion occurs when a fractured bone heals in an abnormal position. Depending on the severity, additional malunion symptoms can include:

Reduced functioning in the affected area

Discomfort

Pain

Swelling

Bruising

Cases of malunion do not always require treatment because some will not cause impaired functioning. But if the altered bone positioning is significant and damaging, it often requires surgical treatments to allow for future mobility.

Surgical Treatment Options for a Malunion

Surgical procedures can help realign severe cases of malunion. An orthopaedic surgical procedure called an osteotomy is commonly used to restore the appropriate alignment of bones that have not healed properly. Surgeons can perform the techniques below in an osteotomy to correct a malunion:

Nonunion

A nonunion occurs when a fractured bone fails to heal after an extendedrecovery period. In some cases a bone may require up to nine months to completely heel. If your doctor or surgeon does not see any signs of progressive healing over this extended period of time, you may have a nonunion. In these cases, the body does not produce the necessary bone tissue to repair the broken bone. Depending on the severity of the nonunion, symptoms also can include:

Reduced functioning in the affected area

Discomfort

Pain

Swelling

Bruising

Non-surgical treatment options for nonunions may include electric stimulation or bracing.

Surgical Treatments Options for a Nonunion

To repair a nonunion, orthopaedic surgeons may aim to:

Restore damaged bones and tissues around the nonunion.

Fill bone gaps with plates and stabilize the bone.

Stimulate bone healing using bone-grafts.

With the right medical care and treatments, malunions, nonunions, and bone fractures don’t have to slow you down. If you suspect you have a malunion or nonunion fracture, make an appointment with an orthopaedic specialist. To learn more about orthopaedic surgery at UPMC the visit our Orthopaedic Surgery website or to schedule an appointment with one of our orthopaedic surgeons, call 412-687-3900.